Inflammation and cardiovascular risk in autoimmune diseases: Mechanisms, biomarkers, and clinical implications

The intersection of autoimmune diseases and cardiovascular disease (CVD) represents a critical frontier in modern medicine. Patients with chronic inflammatory and autoimmune conditions exhibit a significantly elevated risk of premature and accelerated cardiovascular events, a phenomenon rooted not only in shared risk factors but also in a deeply intertwined pathophysiology. The persistent inflammatory state characteristic of these disorders creates a proatherogenic environment, leading to systemic effects that manifest as subclinical cardiac involvement long before overt clinical events occur. Recognizing this profound link, professional bodies have issued guidelines advocating for proactive cardiovascular risk management in patients with autoimmune rheumatic diseases, including rheumatoid arthritis (RA), vasculitis, and systemic sclerosis (SSc). This review provides a comprehensive analysis of the full spectrum of cardiovascular biomarkers utilized in this context. This study examines their roles in elucidating disease mechanisms, diagnosing active cardiovascular involvement, monitoring disease activity, predicting future risk, and ultimately guiding personalized therapeutic strategies. The analysis spans from well-established clinical markers to cutting-edge discoveries in proteomics and immunology, offering a holistic view of how molecular indicators are transforming the understanding and management of CVD in autoimmune populations.